 JULY 16 • 2020 | 5

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jewfro
To Your Health
I 

never met my mom’
s dad, but I think 
about him when I go to the doctor. And 
when I didn’
t.
He hired and mentored my pediatrician, 
Dr. May Ling Lie Shuck, over the objections 
of partners who thought a 
Jewish doctor from Baltimore 
named Manes Hecht was 
diversity enough for their 
practice.
At Johns Hopkins, he 
studied under and remained 
lifelong friends with Dr. Helen 
Taussig, who founded the 
field of pediatric cardiology and developed a 
treatment for blue baby syndrome.
As his 1973 Jewish News obituary notes, 
Dr. Hecht came to Detroit to head up the 
Rheumatic Fever Clinic at Children’
s Hospital 
following his tour of duty as a World War II 
medical captain; in Detroit, he was president 
of the Detroit Pediatric Society and a 
founding staff member of Sinai Hospital.
Yet for all this rarefied work, what really 
sustained Grandpa Manes over 40 years 
practicing medicine, even as his own health 
faltered, was the routine and the relation-
ships. He saw patients at his office in the 
Fisher Building, then later the Huntington 
Woods Professional Building, walking home 
for lunch and carrying a leather doctor bag 
for evening house calls.
Dr. Hecht would no doubt disapprove that 
I went 20 years without having a doctor. Dr. 
Shuck retired around the time I got chest 
hair (I hope coincidentally). After that, I 
was lucky and stupid enough to get by with 
a bottle of hydrogen peroxide, Flintstone’
s 
chewables and the occasional Z-pack.
I am pleased, as I think he would be, 
that my stupid luck (caveman behavior vs. 
caveman vitamins) eventually brought me to 
direct primary care.
At first, direct, primary and care sounded to 
me like three random words stuck together to 
make ever more refrigerator magnet poetry 
for the medical industrial complex.
To my pleasant surprise (and good 
health), direct primary care is an antidote to 
much of what causes us to spend nearly 20% 
of our gross domestic product on healthcare 

for a sociological syndrome of stress, strain 
and stratification.
It’
s simpler to describe how direct primary 
care works than how — let me count the 
ways — traditional fee-for-service, even with 
“good” insurance, does not:
I am a member of Plum Health Direct 
Primary Care. Membership costs $49 a 
month. Raquel Orlich is my doctor. 
I guess she’
s other people’
s doctor, too. But 
I can call, email or text (from my $50/month 
phone) Dr. Orlich any 
time I’
m having an 
issue and, if she can’
t solve it remotely, she 
can always see me that day or the following. 
At one point, there were some balloons 
celebrating Dr. Orlich’
s 300th patient. 
Ultimately, she’
ll have around 500. That 
seems like a lot, I thought, especially 
compared to my prior impression that I was 
her only patient.
The average family physician has 2,400 
patients. They see 24 a day, each for about 
20 minutes, about half of which might be 
spent on “charting” their electronic medical 
records. But it has to be face-to-face (or face-
to-chart) or it won’
t be billable to insurance.
Direct primary care does not accept 
insurance. At first, paying dollars (or HSA 
or FSA or Bitcoin or seashells) directly for 
healthcare seems inefficient when you 
have employer-provided coverage. Until 
you realize there’
s no co-pay, co-insur-
ance, deductible, out-of-pocket maximum, 
pharmacy benefits management company, 
in-network, out-of-network, pre-authoriza-
tions, pre-existing conditions, pre-notifica-
tions, death panels, etc. 
And, as is typical with direct primary care, 

there is no cost for visits to Plum Health.
My kids are now Plum Health members 
for $10/month each, following A Tale of Two 
Splinters: 
Before direct primary care, Judah got a 
splinter in his foot that I couldn’
t get out. We 
did the responsible (parental and, it seemed, 
financial) thing and took him to Beaumont 
Urgent Care. After waiting around with a 
weekend crowd whose issues were conspic-
uously more urgent, if not ER gruesome, 
they got the splinter out, took our insurance 
information and sent us on our way.
Then — dog with preexisting condition 
of being dog bites man with high-deductible 
plan — we got a bill for over $500. When I 
called to inquire, the nice lady on the phone 
reassured me that the “actual” cost was some 
$1,200, but Blue Cross Beaumont synergy 
something something you’
re welcome.
Not wanting to be left out, Phoebe got 
a splinter in her finger recently. We texted 
“Dr. Raquel.
” She wrote me right back with 
her availability. I brought Phoebe to the 
office at Michigan and Trumbull. Free street 
parking. Splinter gone. Respectable Band-Aid 
selection. No charge. And now Phoebe wants 
to be either a doctor or Great Dane when she 
grows up.
Grandpa Manes (whose great-grandchil-
dren will be caught up on their shots by the 
end of the month) loved chamber music. 
Perhaps it reminded him of what he aspired 
to in his doctor-patient relationships. Not 
composing or conducting — not virtuosic 
solo performance — but creating space and 
tuning your ear as much as your expertise to 
the pursuit of humble, healthy harmony. 

Ben Falik

Dr. Raquel removes 
Phoebe’
s splinter.

